Violence in Health Care Reporting app - Process Book

CORE DESIGN 310: ASSIGNMENT TWO

Violence in Health Care Reporting Application Cheryl Li, Lauren Henderson

Table of Contents Contextual Research Literature Review

6

Current System

10

Co-creation Session

12

Precedence

18

Exploration Ideation Process

22

Thesis

24

Personas

25

User Flow & Wireframes

28

Conceptual Development & Refinement Color + Type Selection

32

Interactivity

34

Technology and Application

35

Refinements

36

Final Proposed Solution Final Outcome

40

Rationale

52

GANTT Chart + Self Assessment

56

Bibliography

58

Contextual Research

Contextual Research

CONTEXTUAL RESEARCH

Literary Review Examining Reporting & Its Culture

V “This lack of a centralized reporting device proves to be one of the barriers in creating a place where all the information and reporting forms can be easily accessed and standardized.”

iolence and aggression is a preva-

According to Violence in Healthcare Worker

lent problem in the Health Care field,

Survey - Research Update, violence is seen

which causes both physical and mental

as an accepted part of the job, which leads

repercussions for workers. Statistics show

to under-reporting of violence and aggres-

that 80% of health care workers have

sion in the workplace. There is often more

reported patient to worker violence. As

tolerance for verbal abuse rather than phys-

defined by the Provincial Violence Preven-

ical abuse, although both are still under-

tion Steering Committee (PVPSC), violence

reported. With verbal violence, only 52%

is verbal or physical aggressive behavior

is reported verbally and 28% reported in

that is intended, or not intended due to

writing. Whereas in physical violence, 71%

illness, injury, or lack the mental capacity

is reported verbally and 57% reported in

to demonstrate intent. Under these circum-

writing. With such low rates of reporting, it

stances, 91% of health care workers agree

is difficult for administration to conduct fur-

that violent incidents are underreported.

ther research and receive funding for imple-

Even with this awareness, underreporting

menting violence prevention programs. To

is still a prevalent issue. With this in mind,

solve this, PVPSC recommends promoting

our research explores current statistics of

a positive reporting culture by identifying

reporting, as well as both the administrative

barriers and developing interventions to

and cultural reasons for under reporting.

overcome them. An open and continued

Without reporting, there is a lack of clear

dialogue between administration and the

data and awareness around the issue and

front line workers is also emphasized.

therefore a culture that normalizes violence

Through our co-creation session with the

unknowingly. With this lack of research

Vancouver Coastal Health nurses, we have

comes a lack of funding to implement solu-

found many systematic barriers to report-

tions.

ing violent incidents, one of them being

In examining this reporting system, we

the issue that there is a wide variety of ways

intend to find a means to create a positive

to file these reports, but no centralized

reporting culture where the health care

system. These channels of communication

workers feel systemically supported to

can include an electronic and paper chart,

report any violent incidents.

meetings, or just word of mouth through

As mentioned above, the extent of underre-

colleagues. It seems that some older nurses

porting violence is prevalent in Health Care.

aren’t as computer literate and don’t feel

6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

comfortable documenting electronically, whereas the younger nurses prefer using that method. This lack of a centralized reporting device proves to be one of the barriers in creating a place where all the information and reporting forms can be easily accessed and standardized. This then causes a variety of different information

being a task-oriented job. Because of this,

that in turn is hard to process and translate

reporting often falls to the back burner and

to tangible results.

is forgotten or perceived as unimportant in

Through our research, other systemic

Cheryl and participant at Co-creation Session

comparison.

reasons for under-reporting have emerged.

As a nurse in the Trauma Department (ER)

One main reason is the poor communication

said in our generative session, if an incident

to the workers in when, what, and why to

doesn’t get reported the day of, it often

report. Workers are currently confused as to

doesn’t get reported at all. The incident

what incidents qualify as “harmful” enough.

report forms take approximately twenty min-

This confusion was displayed by one of the

utes to fill out. Twenty minutes may seem

nurses in our co-creation session. From

short to us; a nurse reads it otherwise. Our

information found on a poster in an office,

co-creator emphasized that reporting only

she found herself unsure if she was sup-

depends on how much time and energy she

tration and even

posed to report to higher authorities outside

has left after a long day. It also seems that if

loneliness with this

of her ward. She claimed that instead she

the worker takes the time to fill out a form,

would only tell her colleagues and maybe

more time will have to be dedicated later on

delay, and won-

email her manager later. She concluded that

for follow-ups. Another co-creator said that

she wasn’t clear on what kind of violence

the one time she did report by calling the

somethingw as ever

qualified as important enough to report,

Employee Event Report Line, she received

going to be done

and that after she reported she probably

an automated message that asked her to

wouldn’t do it again.

leave her contact information. Two weeks

with her report.”

In addition to the lack of a centralized sys-

“The co-creator experienced frus-

dered whether

later, she finally had someone call her back

tem and an engaging communication strat-

and ask her to type out the event’s details in

egy, the issue is complicated by health care

the system.

CONTEXTUAL RESEARCH | 7

CONTEXTUAL RESEARCH

Literary Review Examining Reporting & Its Culture

V “This lack of a centralized reporting device proves to be one of the barriers in creating a place where all the information and reporting forms can be easily accessed and standardized.”

iolence and aggression is a preva-

According to Violence in Healthcare Worker

lent problem in the Health Care field,

Survey - Research Update, violence is seen

which causes both physical and mental

as an accepted part of the job, which leads

repercussions for workers. Statistics show

to under-reporting of violence and aggres-

that 80% of health care workers have

sion in the workplace. There is often more

reported patient to worker violence. As

tolerance for verbal abuse rather than phys-

defined by the Provincial Violence Preven-

ical abuse, although both are still under-

tion Steering Committee (PVPSC), violence

reported. With verbal violence, only 52%

is verbal or physical aggressive behavior

is reported verbally and 28% reported in

that is intended, or not intended due to

writing. Whereas in physical violence, 71%

illness, injury, or lack the mental capacity

is reported verbally and 57% reported in

to demonstrate intent. Under these circum-

writing. With such low rates of reporting, it

stances, 91% of health care workers agree

is difficult for administration to conduct fur-

that violent incidents are underreported.

ther research and receive funding for imple-

Even with this awareness, underreporting

menting violence prevention programs. To

is still a prevalent issue. With this in mind,

solve this, PVPSC recommends promoting

our research explores current statistics of

a positive reporting culture by identifying

reporting, as well as both the administrative

barriers and developing interventions to

and cultural reasons for under reporting.

overcome them. An open and continued

Without reporting, there is a lack of clear

dialogue between administration and the

data and awareness around the issue and

front line workers is also emphasized.

therefore a culture that normalizes violence

Through our co-creation session with the

unknowingly. With this lack of research

Vancouver Coastal Health nurses, we have

comes a lack of funding to implement solu-

found many systematic barriers to report-

tions.

ing violent incidents, one of them being

In examining this reporting system, we

the issue that there is a wide variety of ways

intend to find a means to create a positive

to file these reports, but no centralized

reporting culture where the health care

system. These channels of communication

workers feel systemically supported to

can include an electronic and paper chart,

report any violent incidents.

meetings, or just word of mouth through

As mentioned above, the extent of underre-

colleagues. It seems that some older nurses

porting violence is prevalent in Health Care.

aren’t as computer literate and don’t feel

6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

comfortable documenting electronically, whereas the younger nurses prefer using that method. This lack of a centralized reporting device proves to be one of the barriers in creating a place where all the information and reporting forms can be easily accessed and standardized. This then causes a variety of different information

being a task-oriented job. Because of this,

that in turn is hard to process and translate

reporting often falls to the back burner and

to tangible results.

is forgotten or perceived as unimportant in

Through our research, other systemic

Cheryl and participant at Co-creation Session

comparison.

reasons for under-reporting have emerged.

As a nurse in the Trauma Department (ER)

One main reason is the poor communication

said in our generative session, if an incident

to the workers in when, what, and why to

doesn’t get reported the day of, it often

report. Workers are currently confused as to

doesn’t get reported at all. The incident

what incidents qualify as “harmful” enough.

report forms take approximately twenty min-

This confusion was displayed by one of the

utes to fill out. Twenty minutes may seem

nurses in our co-creation session. From

short to us; a nurse reads it otherwise. Our

information found on a poster in an office,

co-creator emphasized that reporting only

she found herself unsure if she was sup-

depends on how much time and energy she

tration and even

posed to report to higher authorities outside

has left after a long day. It also seems that if

loneliness with this

of her ward. She claimed that instead she

the worker takes the time to fill out a form,

would only tell her colleagues and maybe

more time will have to be dedicated later on

delay, and won-

email her manager later. She concluded that

for follow-ups. Another co-creator said that

she wasn’t clear on what kind of violence

the one time she did report by calling the

somethingw as ever

qualified as important enough to report,

Employee Event Report Line, she received

going to be done

and that after she reported she probably

an automated message that asked her to

wouldn’t do it again.

leave her contact information. Two weeks

with her report.”

In addition to the lack of a centralized sys-

“The co-creator experienced frus-

dered whether

later, she finally had someone call her back

tem and an engaging communication strat-

and ask her to type out the event’s details in

egy, the issue is complicated by health care

the system.

CONTEXTUAL RESEARCH | 7

One of our co-creators indicating who she is realistically comfortable in confiding with after a violent incident.

“Many nurses simply don’t report because they feel a lack of sup-

The co-creator experienced frustration and even loneliness with this delay, and wondered whether something was ever going to be done with her report.

because they feel a lack of support from their

culture, a change in the administrative and

in reporting incidents, which will then lead

A co-creation activity

colleagues and administration- as a co-cre-

cultural systems in health care surrounding

to more research and funding that can be

that explores to who

ator noted, she would find trouble telling

reporting violence and aggression needs to

translated into strong violence prevention

her manager and supervisor about a violent

happen. These changes may include making

programs for the future. •

incident, because she felt that they weren’t

the reporting process easier, having a better

supportive. In some health care facilities,

and more engaging communication strategy

only the most serious incidents are reported,

of the importance of reporting, having more

and just because reports are required for the

perceived support in the act of reporting,

workers’ compensation board to pay. This

and translating reports to tangible, significant

peer pressure from nursing staff is definitely

positive improvements. One of our co-cre-

an issue that causes under-reporting.

ators, who comes from a tight-knit ward

The engrained care culture in health care is

with very open communication and virtually

something else that supports under-report-

no stigma surrounding reporting, said that

ing. Care culture is the placement of care

communication and an open mindset are

istrative system operates in such a way that

for patients by the nurses over their own

keys to creating a positive reporting culture.

doesn’t support reporting; however, it’s

well-being. They often don’t report incidents

In her ward, communication can happen in

important to also consider that much of

because they don’t perceive their safety and

both written and verbal form in addition to

under reporting is also due to the cultur-

dignity to be as important as the well-be-

sit-down meetings. She said that they also

al system in health care. Some health care

ing of the patient. Health care workers don’t

do team-building exercises, and emphasize

cultures attach stigma to reporting vio-

like flagging a patient as violent or aggres-

open communication between everyone –

lence. Stigma can include shaming, threats

sive, because they understand that it is not

colleagues, managers and supervisors.

of further violence, isolation, and fear of

the patient’s intention to act violently, but

judgment. One of our co-creators said that

rather it is caused by frustration, agitation, or

Health Care sector suggests that reporting

when she experienced a serious physical

mental health disabilities. In addition, a flag

provides nurses with an opportunity to com-

This evidence demonstrates that the admin-

Our research in reporting culture in the

port from their

assault and had to file a police report and

on their chart is similar to having a criminal

municate existing issues of violence to each

go for a medical check-up, she felt “degrad-

record in the health care world – it greatly

other, while also sharing preventative advice

colleagues and

ed”. Another nurse noted that after facing a

affects how they will be treated in medical

for the future. It also demonstrates that by

administration.”

violent incident she felt stupid in front of her

facilities in the future. The sense of apathy

creating this sharing culture they also can put

co-workers for not knowing how to prevent

for violence and aggression grows with

an end to the acceptance and normalization

it first. Nurses often perceive that reporting

health care culture. Because of this apathy,

of violence. In combating the issue of under

would upset administrators and the resulting

violence is then normalized therefore caus-

reporting, it will lead to obtaining clear data

repercussions would be worse than the initial

ing under-reporting.

and hopefully create a positive reporting

incident. Many nurses simply don’t report 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

In order to create a positive reporting

and with what nurses currently report.

culture and a system that supports workers CONTEXTUAL RESEARCH | 9

One of our co-creators indicating who she is realistically comfortable in confiding with after a violent incident.

“Many nurses simply don’t report because they feel a lack of sup-

The co-creator experienced frustration and even loneliness with this delay, and wondered whether something was ever going to be done with her report.

because they feel a lack of support from their

culture, a change in the administrative and

in reporting incidents, which will then lead

A co-creation activity

colleagues and administration- as a co-cre-

cultural systems in health care surrounding

to more research and funding that can be

that explores to who

ator noted, she would find trouble telling

reporting violence and aggression needs to

translated into strong violence prevention

her manager and supervisor about a violent

happen. These changes may include making

programs for the future. •

incident, because she felt that they weren’t

the reporting process easier, having a better

supportive. In some health care facilities,

and more engaging communication strategy

only the most serious incidents are reported,

of the importance of reporting, having more

and just because reports are required for the

perceived support in the act of reporting,

workers’ compensation board to pay. This

and translating reports to tangible, significant

peer pressure from nursing staff is definitely

positive improvements. One of our co-cre-

an issue that causes under-reporting.

ators, who comes from a tight-knit ward

The engrained care culture in health care is

with very open communication and virtually

something else that supports under-report-

no stigma surrounding reporting, said that

ing. Care culture is the placement of care

communication and an open mindset are

istrative system operates in such a way that

for patients by the nurses over their own

keys to creating a positive reporting culture.

doesn’t support reporting; however, it’s

well-being. They often don’t report incidents

In her ward, communication can happen in

important to also consider that much of

because they don’t perceive their safety and

both written and verbal form in addition to

under reporting is also due to the cultur-

dignity to be as important as the well-be-

sit-down meetings. She said that they also

al system in health care. Some health care

ing of the patient. Health care workers don’t

do team-building exercises, and emphasize

cultures attach stigma to reporting vio-

like flagging a patient as violent or aggres-

open communication between everyone –

lence. Stigma can include shaming, threats

sive, because they understand that it is not

colleagues, managers and supervisors.

of further violence, isolation, and fear of

the patient’s intention to act violently, but

judgment. One of our co-creators said that

rather it is caused by frustration, agitation, or

Health Care sector suggests that reporting

when she experienced a serious physical

mental health disabilities. In addition, a flag

provides nurses with an opportunity to com-

This evidence demonstrates that the admin-

Our research in reporting culture in the

port from their

assault and had to file a police report and

on their chart is similar to having a criminal

municate existing issues of violence to each

go for a medical check-up, she felt “degrad-

record in the health care world – it greatly

other, while also sharing preventative advice

colleagues and

ed”. Another nurse noted that after facing a

affects how they will be treated in medical

for the future. It also demonstrates that by

administration.”

violent incident she felt stupid in front of her

facilities in the future. The sense of apathy

creating this sharing culture they also can put

co-workers for not knowing how to prevent

for violence and aggression grows with

an end to the acceptance and normalization

it first. Nurses often perceive that reporting

health care culture. Because of this apathy,

of violence. In combating the issue of under

would upset administrators and the resulting

violence is then normalized therefore caus-

reporting, it will lead to obtaining clear data

repercussions would be worse than the initial

ing under-reporting.

and hopefully create a positive reporting

incident. Many nurses simply don’t report 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

In order to create a positive reporting

and with what nurses currently report.

culture and a system that supports workers CONTEXTUAL RESEARCH | 9

CONTEXTUAL RESEARCH

Current System Paper Reporting Forms The current system in place at Vancouver

Violence Prevention Training System

General Hospital uses a variety of different

Health Services of BC has provided this online

forms and platforms. They use SLS Electronic

learning course to train nurses in how, what,

Charting in addition to various paper forms

when and why to report violence in the work

displayed to the right. These forms demon-

place. We looked into Module 7 and 8 which

strate the extent of information that the

covers post-incident response as well as Behav-

nurses must fill out after a violent incident

ioral Care Planning for violence. These modules

and the time it must take to do so.

outline specific things to consider when filing a

Figure A, B, C Incident forms found

violence report as well as the effective ways of

in Work Safe BC’s “Preventing Violence in

documenting patient behavior as a preventative

Health Care - 5 Steps”.

Figure D is in the guideline booklet for

Figure A

Figure B

Code White response in hospitals. Booklet

method. We found that this was the only instance where nurses were informed about the reasons they should be reporting.

made in partnership with OHSAH, Workers’

Module 7 specifically explains how, when and

Compensation Board and the Health Associ-

why to fill out an Employee Incident Report as

ation of BC.

we showed on the previous page, as well as how to check yourself after an incident has occurred.

This asks the nurse to take care of themselves first. It also notes that these events should also be documented in the patient’s care plan. The modules also give resources that nurses can use in the case of a violent incident such as counseling and compensation sources.

Module 8 speaks more of preventative methFigure C

Figure D

ods in creating a Patient Violence Risk Assessment. This is meant to keep an active record of the patient’s potential for violence. Including it in their chart or even as a sticker warning on their chart or bracelet is encouraged. The module notes that this system will help the patient receive better care.

1 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 11

CONTEXTUAL RESEARCH

Current System Paper Reporting Forms The current system in place at Vancouver

Violence Prevention Training System

General Hospital uses a variety of different

Health Services of BC has provided this online

forms and platforms. They use SLS Electronic

learning course to train nurses in how, what,

Charting in addition to various paper forms

when and why to report violence in the work

displayed to the right. These forms demon-

place. We looked into Module 7 and 8 which

strate the extent of information that the

covers post-incident response as well as Behav-

nurses must fill out after a violent incident

ioral Care Planning for violence. These modules

and the time it must take to do so.

outline specific things to consider when filing a

Figure A, B, C Incident forms found

violence report as well as the effective ways of

in Work Safe BC’s “Preventing Violence in

documenting patient behavior as a preventative

Health Care - 5 Steps”.

Figure D is in the guideline booklet for

Figure A

Figure B

Code White response in hospitals. Booklet

method. We found that this was the only instance where nurses were informed about the reasons they should be reporting.

made in partnership with OHSAH, Workers’

Module 7 specifically explains how, when and

Compensation Board and the Health Associ-

why to fill out an Employee Incident Report as

ation of BC.

we showed on the previous page, as well as how to check yourself after an incident has occurred.

This asks the nurse to take care of themselves first. It also notes that these events should also be documented in the patient’s care plan. The modules also give resources that nurses can use in the case of a violent incident such as counseling and compensation sources.

Module 8 speaks more of preventative methFigure C

Figure D

ods in creating a Patient Violence Risk Assessment. This is meant to keep an active record of the patient’s potential for violence. Including it in their chart or even as a sticker warning on their chart or bracelet is encouraged. The module notes that this system will help the patient receive better care.

1 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 11

CONTEXTUAL RESEARCH

Co-Creation Activities

Not Comfortable: You would not mention or talk about the issue at all to these people.

Not very comfortable: You are hesitant to talk about the issue with these people. You may or may not disclose.

Systemic Methods of Reporting In this Co-Creation activity participants are asked to write out an incident they have

Somewhat Comfortable: You will talk about the issue with these people if they ask.

Most Comfortable: You talk about the issue with these people willingly.

experienced or witnessed and then place it according to if they would tell anyone or not.

Then depending on what direction they chose they would proceed to place words provided in an envelope under each question to answer who they would tell, with what, when and where. In addition, if an option they need but is not provided they have the option of writing it in. After this is complete, they will take out an envelope marked emotions and place the cut out faces where they were feeling what according to their previous answers.

This activity allowed us to collect data about what systems of reporting are currently in place as well as if nurse also tell people outside of their work environment. By attaching emotions to each section we could see how they felt about current applications versus their personal recounts of the events.

Social Connections in Reporting This activity gave the participants two scenar-

For the second scenario the participant is

ios. In one, a nurse is scratched by a patient,

presented with, they are injured by a patient

but the patient does not leave a visible mark.

and this time leaves a visible mark. She will

Using sticky notes, the co-creator must place

go through the activity again with this new

the named positions of the people that they

scenario in mind.

are supposed to report to. The bulls eye

This activity was meant to give us insight

shape of the above graphic shows a high

into the gaps around who they are meant to

level of comfort in telling near the center and

report to, who they are actually comfortable

a lesser level of comfort as you move out

enough to report to, and who they would

towards the edge. Once this is completed

ideally like to report to. In addition, it will in-

the participant will place new sticky notes of

form us about what individuals feel is severe

who they actually tell, and again for who they

enough to report.

would ideally like to tell.

1 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 13

CONTEXTUAL RESEARCH

Co-Creation Activities

Not Comfortable: You would not mention or talk about the issue at all to these people.

Not very comfortable: You are hesitant to talk about the issue with these people. You may or may not disclose.

Systemic Methods of Reporting In this Co-Creation activity participants are asked to write out an incident they have

Somewhat Comfortable: You will talk about the issue with these people if they ask.

Most Comfortable: You talk about the issue with these people willingly.

experienced or witnessed and then place it according to if they would tell anyone or not.

Then depending on what direction they chose they would proceed to place words provided in an envelope under each question to answer who they would tell, with what, when and where. In addition, if an option they need but is not provided they have the option of writing it in. After this is complete, they will take out an envelope marked emotions and place the cut out faces where they were feeling what according to their previous answers.

This activity allowed us to collect data about what systems of reporting are currently in place as well as if nurse also tell people outside of their work environment. By attaching emotions to each section we could see how they felt about current applications versus their personal recounts of the events.

Social Connections in Reporting This activity gave the participants two scenar-

For the second scenario the participant is

ios. In one, a nurse is scratched by a patient,

presented with, they are injured by a patient

but the patient does not leave a visible mark.

and this time leaves a visible mark. She will

Using sticky notes, the co-creator must place

go through the activity again with this new

the named positions of the people that they

scenario in mind.

are supposed to report to. The bulls eye

This activity was meant to give us insight

shape of the above graphic shows a high

into the gaps around who they are meant to

level of comfort in telling near the center and

report to, who they are actually comfortable

a lesser level of comfort as you move out

enough to report to, and who they would

towards the edge. Once this is completed

ideally like to report to. In addition, it will in-

the participant will place new sticky notes of

form us about what individuals feel is severe

who they actually tell, and again for who they

enough to report.

would ideally like to tell.

1 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 13

CONTEXTUAL RESEARCH

Co-Creation Findings

“Maybe you’ll feel stupid because of what you didn’t do right” –One of our co-creators on reporting to her colleagues after an incident

From this activity we gathered some expected and unexpected data. We learned that there are a variety of different reporting and safety mechanisms in place already, but no centralized reporting system. We found that nurses are not apprehensive to share information of violent events with their co-workers, but rather they are cautious when sharing with family members and friends due to patient privacy laws. The most useful part of this activity was the emotions as we found some surprises in what nurses feel when reporting. For example they feel, lonely, stupid, confused, overwhelmed and frustrated, just to mention a few.

Detailed results of co-creation data found from a variety of participant nurses 1 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

From this activity we got a great idea about who nurses feel comfortable telling versus who they are supposed to tell. This opened them up for further conversation about their working environment and how they feel when they have to fill out reports. We found that their greatest support came from co-workers and they were very comfortable telling them about incidents informally. However, when it came to formal reporting we found that there are many mixed feelings. Some nurses are more hesitant to tell their supervisor or manager as they are not as close with them. We even received feedback that filling out police and medical reports makes them feel almost degraded.

This emphasized that there is an engrained problem not just systemically, but also culturally with the current reporting system. There seems to be a lack of perceived support and stigma within the workplace about reporting a violent incident.

CONTEXTUAL RESEARCH | 15

CONTEXTUAL RESEARCH

Co-Creation Findings

“Maybe you’ll feel stupid because of what you didn’t do right” –One of our co-creators on reporting to her colleagues after an incident

From this activity we gathered some expected and unexpected data. We learned that there are a variety of different reporting and safety mechanisms in place already, but no centralized reporting system. We found that nurses are not apprehensive to share information of violent events with their co-workers, but rather they are cautious when sharing with family members and friends due to patient privacy laws. The most useful part of this activity was the emotions as we found some surprises in what nurses feel when reporting. For example they feel, lonely, stupid, confused, overwhelmed and frustrated, just to mention a few.

Detailed results of co-creation data found from a variety of participant nurses 1 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

From this activity we got a great idea about who nurses feel comfortable telling versus who they are supposed to tell. This opened them up for further conversation about their working environment and how they feel when they have to fill out reports. We found that their greatest support came from co-workers and they were very comfortable telling them about incidents informally. However, when it came to formal reporting we found that there are many mixed feelings. Some nurses are more hesitant to tell their supervisor or manager as they are not as close with them. We even received feedback that filling out police and medical reports makes them feel almost degraded.

This emphasized that there is an engrained problem not just systemically, but also culturally with the current reporting system. There seems to be a lack of perceived support and stigma within the workplace about reporting a violent incident.

CONTEXTUAL RESEARCH | 15

CONTEXTUAL RESEARCH

Co-Creation Reflections

Our co-creation activities reaped a variety of unexpected results, ranging from seeing nothing wrong with the current system to feeling a real need for change and improvement.

From the co-creation session, we found that many of our assumptions going in were misinformed. One of the biggest surprises was that not all of them felt it was necessary to have change or that there was a problem that needed fixing. This informed us that either the problem is so deeply normalized or that nurses are actually happy with the current system. We also gained insight into the main cause of underreporting, finding that it had to do with the lack of time. One nurse mentioned that if a report was not filed the day of the incident, it most likely would never get filed. Confusion also surrounded why, what and when nurses should be reporting.

Also, they don’t see where the report goes and therefore feel like nothing is being done about their report and their voices aren’t being heard.

Most importantly, we came away from our co-creation with a greater understanding and a much greater empathy for nurses.

1 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Looking at our findings of causes, assumptions, solutions, and emotions around the issue of violence. We found that we had many similar findings as our classmates, which reinforced the importance of that point.

CONTEXTUAL RESEARCH | 17

CONTEXTUAL RESEARCH

Co-Creation Reflections

Our co-creation activities reaped a variety of unexpected results, ranging from seeing nothing wrong with the current system to feeling a real need for change and improvement.

From the co-creation session, we found that many of our assumptions going in were misinformed. One of the biggest surprises was that not all of them felt it was necessary to have change or that there was a problem that needed fixing. This informed us that either the problem is so deeply normalized or that nurses are actually happy with the current system. We also gained insight into the main cause of underreporting, finding that it had to do with the lack of time. One nurse mentioned that if a report was not filed the day of the incident, it most likely would never get filed. Confusion also surrounded why, what and when nurses should be reporting.

Also, they don’t see where the report goes and therefore feel like nothing is being done about their report and their voices aren’t being heard.

Most importantly, we came away from our co-creation with a greater understanding and a much greater empathy for nurses.

1 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Looking at our findings of causes, assumptions, solutions, and emotions around the issue of violence. We found that we had many similar findings as our classmates, which reinforced the importance of that point.

CONTEXTUAL RESEARCH | 17

CONTEXTUAL RESEARCH

Precedence: Recording Apps

After looking at existing solutions and our research, we started looking at different recording and tracking apps that used different behavior change mechanisms. This was done keeping in mind our goal of making the reporting process easier, more efficient, and less intimidating to do.

Lift is a behavior change interface on the web and an app. It prompts you create habits that you want to work towards, and then incorporates a social media aspect so that others can see your goals and “lift” you. You Mint

can also track your own progress for a sense of achievement.

Frog Design’s Connected Care is a recording app for patients to take control of their own healthcare by self reporting any changes that occur in their health. This then allows the app to make any recommendations, as well as improves communication between the patient and the physician. This app also has a social media aspect to allow patients to share their health progress.

Mint is a web interface and an app that helps you track your finances. Mint includes plenty of visualizations of your budgets and your spendings, so that you are able to track your finances easily and quickly.

Lift 1 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Frog Design’s Connected Care CONTEXTUAL RESEARCH | 19

CONTEXTUAL RESEARCH

Precedence: Recording Apps

After looking at existing solutions and our research, we started looking at different recording and tracking apps that used different behavior change mechanisms. This was done keeping in mind our goal of making the reporting process easier, more efficient, and less intimidating to do.

Lift is a behavior change interface on the web and an app. It prompts you create habits that you want to work towards, and then incorporates a social media aspect so that others can see your goals and “lift” you. You Mint

can also track your own progress for a sense of achievement.

Frog Design’s Connected Care is a recording app for patients to take control of their own healthcare by self reporting any changes that occur in their health. This then allows the app to make any recommendations, as well as improves communication between the patient and the physician. This app also has a social media aspect to allow patients to share their health progress.

Mint is a web interface and an app that helps you track your finances. Mint includes plenty of visualizations of your budgets and your spendings, so that you are able to track your finances easily and quickly.

Lift 1 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Frog Design’s Connected Care CONTEXTUAL RESEARCH | 19

Exploration

Exploration

E X P L O R AT I O N

Ideation Process

We spent a large part of our time after the research stage defining our problem space and ideating possible solutions.

We constantly returned to our problem statement, and asking ourselves how each idea would solve that.

The main problems surrounding reporting violence

Defining the initial problem space

Refining problem down to a manageable size

Defining the current system’s main problems

Exploring what underreporting causes

Solidifying our problem space and how to solve it

What our design needed to create

Exploring possible features of reporting

2 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 3

E X P L O R AT I O N

Ideation Process

We spent a large part of our time after the research stage defining our problem space and ideating possible solutions.

We constantly returned to our problem statement, and asking ourselves how each idea would solve that.

The main problems surrounding reporting violence

Defining the initial problem space

Refining problem down to a manageable size

Defining the current system’s main problems

Exploring what underreporting causes

Solidifying our problem space and how to solve it

What our design needed to create

Exploring possible features of reporting

2 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 3

E X P L O R AT I O N

Thesis

E X P L O R AT I O N

Personas

We aim to create a centralized reporting application that promotes a positive reporting experience through establishing a sense of action, transparency, and community.

Background: Jane is a caring and empathetic young woman who has been a nurse at VGH for two years now. Her favourite part of the job is really getting to know patients as she interacts with them daily. Jane has always put the people she cares about before herself, especially with her patients.

Jane understands the importance of reporting, but admittedly doesn’t always report verbal violence or minor physical violence that don’t cause injuries because she simply doesn’t have enough time and she would rather take care of her patients. Sometimes, she doesn’t know what exactly qualifies as reporting, especially with more minor incidents. Although her fellow nurses have always been helpful and friendly when an incident has happened and has provided support and comfort, she doesn’t want to file a report and give her supervisor extra

A sense of action is needed because nurses encounter the problem of feeling like nothing is

paperwork to do as she doesn’t want him to get angry.

being done after filing a report. By making the care workers feel like someone is listening to

Jane Chung

them and responding to their reports, it will hopefully increase the rate of reporting.

Vancouver, BC

One afternoon, as Jane is bending over to help one of her patients

27 years old Chinese female

stand up, the patient becomes aggravated and slaps her arm down,

Single

leaving a red mark. A bit startled, she leaves and goes to the nursing

Lives alone

station. VGH has recently implemented a new reporting app, and

Works in VGH Long-term Residence Care

after opening it she goes to “About” and finds out that the incident

Has been working for 2 years now as a nurse

that just happened requires a report. She fills out the report, and is

Empathetic, Quick Learner, Determined

surprised at how little time it takes and is back to work in less than 10

A sense of transparency is needed because care workers often don’t know where their report goes after they’ve taken the time to file one, thus discouraging them from reporting in the future. If there is a way for them to keep track of the reporting process and see where exactly their report is at, this will hopefully boost the rate of reporting.

A sense of community is especially important because of the cultural barriers to reporting that

Scenario:

are evident in some workplaces. Nurses always often don’t put themselves first, but rather

minutes. Later on, she enjoys the little check-up that pops up asking

their patients and their colleagues. Therefore, it is especially important for us to harness that

her if she’s ok, and all the “appreciates” she has been getting from her

sense of care and establish that reporting will help others as well as themselves. Combating

colleagues who share the same patient- it makes her feel like her re-

the stigma associated with reporting is also another important issue that a building sense of

port was able to help others from getting into the same incident. She

community will need to address.

also requests her supervisor to come see her, and within ten minutes he is providing her with all the support and resources that she needs.

She now feels supported by not only her fellow nurses, but also her supervisor as well.

2 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 5

E X P L O R AT I O N

Thesis

E X P L O R AT I O N

Personas

We aim to create a centralized reporting application that promotes a positive reporting experience through establishing a sense of action, transparency, and community.

Background: Jane is a caring and empathetic young woman who has been a nurse at VGH for two years now. Her favourite part of the job is really getting to know patients as she interacts with them daily. Jane has always put the people she cares about before herself, especially with her patients.

Jane understands the importance of reporting, but admittedly doesn’t always report verbal violence or minor physical violence that don’t cause injuries because she simply doesn’t have enough time and she would rather take care of her patients. Sometimes, she doesn’t know what exactly qualifies as reporting, especially with more minor incidents. Although her fellow nurses have always been helpful and friendly when an incident has happened and has provided support and comfort, she doesn’t want to file a report and give her supervisor extra

A sense of action is needed because nurses encounter the problem of feeling like nothing is

paperwork to do as she doesn’t want him to get angry.

being done after filing a report. By making the care workers feel like someone is listening to

Jane Chung

them and responding to their reports, it will hopefully increase the rate of reporting.

Vancouver, BC

One afternoon, as Jane is bending over to help one of her patients

27 years old Chinese female

stand up, the patient becomes aggravated and slaps her arm down,

Single

leaving a red mark. A bit startled, she leaves and goes to the nursing

Lives alone

station. VGH has recently implemented a new reporting app, and

Works in VGH Long-term Residence Care

after opening it she goes to “About” and finds out that the incident

Has been working for 2 years now as a nurse

that just happened requires a report. She fills out the report, and is

Empathetic, Quick Learner, Determined

surprised at how little time it takes and is back to work in less than 10

A sense of transparency is needed because care workers often don’t know where their report goes after they’ve taken the time to file one, thus discouraging them from reporting in the future. If there is a way for them to keep track of the reporting process and see where exactly their report is at, this will hopefully boost the rate of reporting.

A sense of community is especially important because of the cultural barriers to reporting that

Scenario:

are evident in some workplaces. Nurses always often don’t put themselves first, but rather

minutes. Later on, she enjoys the little check-up that pops up asking

their patients and their colleagues. Therefore, it is especially important for us to harness that

her if she’s ok, and all the “appreciates” she has been getting from her

sense of care and establish that reporting will help others as well as themselves. Combating

colleagues who share the same patient- it makes her feel like her re-

the stigma associated with reporting is also another important issue that a building sense of

port was able to help others from getting into the same incident. She

community will need to address.

also requests her supervisor to come see her, and within ten minutes he is providing her with all the support and resources that she needs.

She now feels supported by not only her fellow nurses, but also her supervisor as well.

2 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 5

Background:

Background:

Even after 25 years of experience, Elaine still encounters violence and

Graham has noted that his nurses often do not report violent inci-

aggression with her patients. She has learnt that when working with

dences in his ward. Without this information he cannot properly make

elderly patients, you never know what to expect.

recommendations for the safety of the staff nor receive funding for

Elaine and her colleagues understands the importance of reporting,

programs to help them gain better knowledge of violence preven-

but admittedly don’t always report verbal violence or minor violent

tion. He understands that the nurses are extremely busy, and so is

incidents that only cause light injuries because they understand it’s

he. Their reporting also gives him more work on top of all the work

not the patients’ fault for being aggressive. However, her and her

he already has on his plate. He has seen this never ending cycle of a

fellow nurses have built a tight community to take care of each other.

problem for all the years he has been supervisor.

She has a very close bond with her colleagues, and always aims to

Scenario:

look out for their safety and well-being.

The app system has been functioning for 3 months now, and with this

Scenario:

new system of fully electronic reporting he doesn`t have an unnec-

Her hospital has decided to implement a new system of reporting

essary amount of paperwork on his desk. The nurses are also less

Elaine Smith

that involves a newer technology. Elaine is a little uncomfortable with

apprehensive to reporting now. With all this new information coming

this change as she fears that she will not understand how to use this

Graham Hill

Surrey, BC

new technology. After going through a workshop with it she feels

40 year old Caucasian male

crease violence, as well as a proposal for funding to implement a pro-

55 years old Caucasian female

a little more comfortable, but still apprehensive. One day, Elaine

Works in VGH Long-term Residence Care as

gram to improve skills in de-escalation, communication, and violence

Married

receives a notification on her reporting app letting her know that

a Supervisor

prevention. One day, Graham is in his office and he receives a call

Mother of 2 girls

one of her clients, Joe, has assaulted a nurse and is in an aggravated

Responsible, caring, resourceful

that a nurse wants to speak with him in within the next thirty minutes.

Works in VGH Long-term Residence Care

state. Elaine appreciates the notification, as she is just about to see

He finishes his previous task and finds the nurse who is uncertain with

Has been a nurse for 25 years

Joe next. When she does see Joe, she makes sure to follow proce-

what to do after going through a violent incident. He is able to calm

Empathetic, Loving, Wise

dure and take all the necessary precautions to ensure her own safety.

her down and provide support and resources that she needed in a

Elaine now understands and appreciates the importance of this app

timely fashion.

in, he is able to put together a report full of recommendations to de-

to keep her colleagues safe and updated.

2 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 7

Background:

Background:

Even after 25 years of experience, Elaine still encounters violence and

Graham has noted that his nurses often do not report violent inci-

aggression with her patients. She has learnt that when working with

dences in his ward. Without this information he cannot properly make

elderly patients, you never know what to expect.

recommendations for the safety of the staff nor receive funding for

Elaine and her colleagues understands the importance of reporting,

programs to help them gain better knowledge of violence preven-

but admittedly don’t always report verbal violence or minor violent

tion. He understands that the nurses are extremely busy, and so is

incidents that only cause light injuries because they understand it’s

he. Their reporting also gives him more work on top of all the work

not the patients’ fault for being aggressive. However, her and her

he already has on his plate. He has seen this never ending cycle of a

fellow nurses have built a tight community to take care of each other.

problem for all the years he has been supervisor.

She has a very close bond with her colleagues, and always aims to

Scenario:

look out for their safety and well-being.

The app system has been functioning for 3 months now, and with this

Scenario:

new system of fully electronic reporting he doesn`t have an unnec-

Her hospital has decided to implement a new system of reporting

essary amount of paperwork on his desk. The nurses are also less

Elaine Smith

that involves a newer technology. Elaine is a little uncomfortable with

apprehensive to reporting now. With all this new information coming

this change as she fears that she will not understand how to use this

Graham Hill

Surrey, BC

new technology. After going through a workshop with it she feels

40 year old Caucasian male

crease violence, as well as a proposal for funding to implement a pro-

55 years old Caucasian female

a little more comfortable, but still apprehensive. One day, Elaine

Works in VGH Long-term Residence Care as

gram to improve skills in de-escalation, communication, and violence

Married

receives a notification on her reporting app letting her know that

a Supervisor

prevention. One day, Graham is in his office and he receives a call

Mother of 2 girls

one of her clients, Joe, has assaulted a nurse and is in an aggravated

Responsible, caring, resourceful

that a nurse wants to speak with him in within the next thirty minutes.

Works in VGH Long-term Residence Care

state. Elaine appreciates the notification, as she is just about to see

He finishes his previous task and finds the nurse who is uncertain with

Has been a nurse for 25 years

Joe next. When she does see Joe, she makes sure to follow proce-

what to do after going through a violent incident. He is able to calm

Empathetic, Loving, Wise

dure and take all the necessary precautions to ensure her own safety.

her down and provide support and resources that she needed in a

Elaine now understands and appreciates the importance of this app

timely fashion.

in, he is able to put together a report full of recommendations to de-

to keep her colleagues safe and updated.

2 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 7

E X P L O R AT I O N

User Flow & Wireframes Images of a walk through of some of our wireframe explorations.

We each did separate sketches of our navigation in mind to be able to catch each other’s mistakes.

Figuring out our navigation flow on the white board. This aided us in picturing the whole app in one glance.

Solidifying our navigation became a key and strong point in our design process. With a strong idea of our navigation we found it very easy to step forward into our next phase of design. By understanding what our app aimed to do and figuring out how we could simplify the task of reporting for nurses, we could then begin the process of refining our app and making aesthetic choices.

2 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 9

E X P L O R AT I O N

User Flow & Wireframes Images of a walk through of some of our wireframe explorations.

We each did separate sketches of our navigation in mind to be able to catch each other’s mistakes.

Figuring out our navigation flow on the white board. This aided us in picturing the whole app in one glance.

Solidifying our navigation became a key and strong point in our design process. With a strong idea of our navigation we found it very easy to step forward into our next phase of design. By understanding what our app aimed to do and figuring out how we could simplify the task of reporting for nurses, we could then begin the process of refining our app and making aesthetic choices.

2 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

E X P L O R AT I O N | 2 9

Conceptual Development + Refinement

Conceptual Development + Refinement

CONCEPTUAL DEVELOPMENT + REFINEMENT

Color + Type Selection While choosing a color palette and type choices, we kept in mind that our users most likely would’ve just experienced a violent or aggressive incident. Therefore, we wanted our color palette to be calming and soothing, but yet empowering and encouraging them to report.

supportive empowering caring Gotham Medium

supportive empowering caring Lato Regular

Supportive Empowering Caring Klinic Slab Book

supportive empowering caring Avenir 55 Roman

supportive empowering caring Gill Sans Regular

F I N A L C O L O R PA L E T T E

FINAL TYPE CHOICES

supportive empowering caring Avenir 65 Medium

3 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Supportive Empowering Caring Klinic Slab Bold Italic

CONCEPTUAL DEVELOPMENT + REFINEMENT | 33

CONCEPTUAL DEVELOPMENT + REFINEMENT

Color + Type Selection While choosing a color palette and type choices, we kept in mind that our users most likely would’ve just experienced a violent or aggressive incident. Therefore, we wanted our color palette to be calming and soothing, but yet empowering and encouraging them to report.

supportive empowering caring Gotham Medium

supportive empowering caring Lato Regular

Supportive Empowering Caring Klinic Slab Book

supportive empowering caring Avenir 55 Roman

supportive empowering caring Gill Sans Regular

F I N A L C O L O R PA L E T T E

FINAL TYPE CHOICES

supportive empowering caring Avenir 65 Medium

3 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Supportive Empowering Caring Klinic Slab Bold Italic

CONCEPTUAL DEVELOPMENT + REFINEMENT | 33

CONCEPTUAL DEVELOPMENT + REFINEMENT

CONCEPTUAL DEVELOPMENT + REFINEMENT

Interactivity

Technology + Application

For the interactive functions and gestures, we took inspiration from the ipad and an app called Clear. We decided to adopt many of these swiping features to minimize the need for tapping, therefore making the entire process a lot more efficient and simple.

The iPad had very easy and clear interaction that used a lot of side swipes to activate drop down menus. Their interactivity was successful in decreasing the amount of space used, as well as increasing the efficiency of use.

7.87 in

Clear is an app that helps you manage your to-do list. Although the function is simple, its interactivity is especially simple and efficient to use. Clear does this by using gestures such as swiping and pinching rather than tapping.

iPad

5.3 in For our project, we decided to use an iPad mini because of its convenient size- small enough to fit into a pocket but large enough to have enough screen space to navigate our app easily and comfortably.

Clear 3 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONCEPTUAL DEVELOPMENT + REFINEMENT | 35

CONCEPTUAL DEVELOPMENT + REFINEMENT

CONCEPTUAL DEVELOPMENT + REFINEMENT

Interactivity

Technology + Application

For the interactive functions and gestures, we took inspiration from the ipad and an app called Clear. We decided to adopt many of these swiping features to minimize the need for tapping, therefore making the entire process a lot more efficient and simple.

The iPad had very easy and clear interaction that used a lot of side swipes to activate drop down menus. Their interactivity was successful in decreasing the amount of space used, as well as increasing the efficiency of use.

7.87 in

Clear is an app that helps you manage your to-do list. Although the function is simple, its interactivity is especially simple and efficient to use. Clear does this by using gestures such as swiping and pinching rather than tapping.

iPad

5.3 in For our project, we decided to use an iPad mini because of its convenient size- small enough to fit into a pocket but large enough to have enough screen space to navigate our app easily and comfortably.

Clear 3 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONCEPTUAL DEVELOPMENT + REFINEMENT | 35

CONCEPTUAL DEVELOPMENT + REFINEMENT

Refinements

In class critique of our black and white print out models.

The above image demonstrates how we simplified the app screens by having the menu all on one page. We decided to use the same motion of swiping down throughout the app for consistency. We also decided to add a “reminder to finish prompt” that we did not have in earlier iterations. From our critiques, and referring back to our research we felt this was important to emphasize that nurses often don’t have time to complete reports and may even forget to finish one. In addition, we refined our icons to simpler forms to avoid confusion between the reporting and tracking reporting symbols.

These icons were simplified to better show the difference between reporting and tracking your report

Upon creating our first draft we found that much of our refinements had to do with the interactive nature of using a touch screen device. Many of our previous iterations such as the ones shown above referred to a paper fill in form with tick boxes and separate pages. By refining this we better utilized the possibilities of using dropdown menus, various gestures and popup selection boxes. Visually there was a couple refinements that had to do with our icons, type size and making sure our form language was the same as current procedures.

3 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Home

Report an Incident

Check Your Report

About

Sign Out

CONCEPTUAL DEVELOPMENT + REFINEMENT | 37

CONCEPTUAL DEVELOPMENT + REFINEMENT

Refinements

In class critique of our black and white print out models.

The above image demonstrates how we simplified the app screens by having the menu all on one page. We decided to use the same motion of swiping down throughout the app for consistency. We also decided to add a “reminder to finish prompt” that we did not have in earlier iterations. From our critiques, and referring back to our research we felt this was important to emphasize that nurses often don’t have time to complete reports and may even forget to finish one. In addition, we refined our icons to simpler forms to avoid confusion between the reporting and tracking reporting symbols.

These icons were simplified to better show the difference between reporting and tracking your report

Upon creating our first draft we found that much of our refinements had to do with the interactive nature of using a touch screen device. Many of our previous iterations such as the ones shown above referred to a paper fill in form with tick boxes and separate pages. By refining this we better utilized the possibilities of using dropdown menus, various gestures and popup selection boxes. Visually there was a couple refinements that had to do with our icons, type size and making sure our form language was the same as current procedures.

3 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Home

Report an Incident

Check Your Report

About

Sign Out

CONCEPTUAL DEVELOPMENT + REFINEMENT | 37

Final Proposed Solution

Final Proposed Solution

FINAL PROPOSED SOLUTION

Final Outcome

Top Bar: The user name presented,

Sign in & PIN Page: You sign in

as to not confuse tablets between

once at the beginning of your shift.

nurses. Also includes time, notifica-

After that you can access the sys-

tions, messages, and sign out.

tem with just your PIN number.

About Page: Defines violence and aggression, and provides ex-

Main Page: From here, you can

amples. Swipe right to access the

Report an Incident, Check Re-

page that tells you why reporting

ports, and go to the About Page.

is a beneficial action. To learn more about each reason, tap on it to read textual information.

tap

swipe 4 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 41

FINAL PROPOSED SOLUTION

Final Outcome

Top Bar: The user name presented,

Sign in & PIN Page: You sign in

as to not confuse tablets between

once at the beginning of your shift.

nurses. Also includes time, notifica-

After that you can access the sys-

tions, messages, and sign out.

tem with just your PIN number.

About Page: Defines violence and aggression, and provides ex-

Main Page: From here, you can

amples. Swipe right to access the

Report an Incident, Check Re-

page that tells you why reporting

ports, and go to the About Page.

is a beneficial action. To learn more about each reason, tap on it to read textual information.

tap

swipe 4 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 41

FINAL PROPOSED SOLUTION

Final Outcome

Report an Incident: These categories are

Supervisor/Counseling check-in:

taken from WorkSafeBC

can be requested immediately

Reporting sample forms They’re streamlined down into eight categories because of the information already stored in

through this form. This creates a swipe down for drop down menu

and Code White forms.

sense of immediacy and action and addresses the issue of care workers feeling like nothing is being done about their report.

the larger system.

Messaging System: A one-way messaging system so that the supervisor can let the care worker know if they are running late, or keep them updated as to when they’ll be able to check-in.

swipe right or tap

4 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 43

FINAL PROPOSED SOLUTION

Final Outcome

Report an Incident: These categories are

Supervisor/Counseling check-in:

taken from WorkSafeBC

can be requested immediately

Reporting sample forms They’re streamlined down into eight categories because of the information already stored in

through this form. This creates a swipe down for drop down menu

and Code White forms.

sense of immediacy and action and addresses the issue of care workers feeling like nothing is being done about their report.

the larger system.

Messaging System: A one-way messaging system so that the supervisor can let the care worker know if they are running late, or keep them updated as to when they’ll be able to check-in.

swipe right or tap

4 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 43

FINAL PROPOSED SOLUTION

Final Outcome

Reminder to finish filling out the report: Since nurses are task-oriented and time-driven, this reminder will pop up if the report isn’t completed to remind them to complete and submit it.

Injuries: You can type in the injury manually, and adjust the severity of it on a sliding scale. You can add another injury by swiping down over the “add another injury”.

Intervention/Resolution & Other Information: These fields are left as blank to be typed out manually, as the interventio methods and other information can be highly varying.

4 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 45

FINAL PROPOSED SOLUTION

Final Outcome

Reminder to finish filling out the report: Since nurses are task-oriented and time-driven, this reminder will pop up if the report isn’t completed to remind them to complete and submit it.

Injuries: You can type in the injury manually, and adjust the severity of it on a sliding scale. You can add another injury by swiping down over the “add another injury”.

Intervention/Resolution & Other Information: These fields are left as blank to be typed out manually, as the interventio methods and other information can be highly varying.

4 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 45

FINAL PROPOSED SOLUTION

Final Outcome swipe right to appreciate

Instant Notifications: These happen once an incident happens.

swipe left to view full report

Report Submitted Page: Once you submit your report, the app thanks you for reporting and lets you know that you are not the only one reporting. This is to combat the stigma that is present surrounding

Only nurses who share the same patient get this notification. Also, there is no identifying information of where the report came from to preserve anonymity, thus boost reporting rates. You van swipe right to view the full report.

reporting, and the fear of being the only one submitting reports.

Appreciate: Other nurses can appreciate the report that has been filed to show that they are glad that another nurse has reported an incident. This is to build communi-

Infographics: These infographics provide stats surrounding violence in health care. This is to

ty, and let the nurse who reported know that she is helping keep her colleagues safe.

provide a larger picture of the issue, and to let the nurse know what her report is helping solve.

Notifications: Lets you know if you missed any appreciates, progress in your report, or reported incident.

tap

4 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 47

FINAL PROPOSED SOLUTION

Final Outcome swipe right to appreciate

Instant Notifications: These happen once an incident happens.

swipe left to view full report

Report Submitted Page: Once you submit your report, the app thanks you for reporting and lets you know that you are not the only one reporting. This is to combat the stigma that is present surrounding

Only nurses who share the same patient get this notification. Also, there is no identifying information of where the report came from to preserve anonymity, thus boost reporting rates. You van swipe right to view the full report.

reporting, and the fear of being the only one submitting reports.

Appreciate: Other nurses can appreciate the report that has been filed to show that they are glad that another nurse has reported an incident. This is to build communi-

Infographics: These infographics provide stats surrounding violence in health care. This is to

ty, and let the nurse who reported know that she is helping keep her colleagues safe.

provide a larger picture of the issue, and to let the nurse know what her report is helping solve.

Notifications: Lets you know if you missed any appreciates, progress in your report, or reported incident.

tap

4 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 47

FINAL PROPOSED SOLUTION

Final Outcome

Counselling Appointment: Once couselling receives your request, they send you possible dates for an appointment by looking at your schedule in the system and determining when you might be free.

swipe right

Instant Booking: By swiping right on an available date, an appointment is instantly made.

This streamlined process contrib-

Check-in’s : At 15 min, halfway

utes to the sense of action that is

through the nurse’s shift, and

necessary to combat the problem

before the end of their shift, a

of nurses feeling like nothing is

notification pops up to check-

being done about their reports.

in with the nurse and offer the options of supervisor check-in, counseling request, and track the report. This is to constantly offer the nurse these options, and to let them know it’s always there.

When you request counseling, it sends the counselor a request for an appointment.

4 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 49

FINAL PROPOSED SOLUTION

Final Outcome

Counselling Appointment: Once couselling receives your request, they send you possible dates for an appointment by looking at your schedule in the system and determining when you might be free.

swipe right

Instant Booking: By swiping right on an available date, an appointment is instantly made.

This streamlined process contrib-

Check-in’s : At 15 min, halfway

utes to the sense of action that is

through the nurse’s shift, and

necessary to combat the problem

before the end of their shift, a

of nurses feeling like nothing is

notification pops up to check-

being done about their reports.

in with the nurse and offer the options of supervisor check-in, counseling request, and track the report. This is to constantly offer the nurse these options, and to let them know it’s always there.

When you request counseling, it sends the counselor a request for an appointment.

4 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 49

FINAL PROPOSED SOLUTION

Final Outcome swipe for more reports

Other reports: You can also view the old reports you filed by swiping

swipe down to view the entire report

left and right.

Track Your Report: When unresolved reports are viewed, the

Colleague Reports: You can also view any reports filed by colleagues who share the same patients.

You can view the entire report, and appreciate the post.

timeline for where the report is at pops up. This lets the nurse know where exactly the report is at in the process, solving the problem of not knowing where the report goes after being filed.

5 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 51

FINAL PROPOSED SOLUTION

Final Outcome swipe for more reports

Other reports: You can also view the old reports you filed by swiping

swipe down to view the entire report

left and right.

Track Your Report: When unresolved reports are viewed, the

Colleague Reports: You can also view any reports filed by colleagues who share the same patients.

You can view the entire report, and appreciate the post.

timeline for where the report is at pops up. This lets the nurse know where exactly the report is at in the process, solving the problem of not knowing where the report goes after being filed.

5 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

FINAL PROPOSED SOLUTION | 51

FINAL PROPOSED SOLUTION

Rationale W

hen Vancouver Coastal Health

in the future where nurses all have tablets

what that may be. They can also swipe right

approached Emily Carr University

that contain a larger system of patient charts

to learn about why reporting would benefit

the option to request a supervisor checkup

and provided us with the problem space of

and information, nurses schedules, and oth-

themselves, their colleagues, their patients,

or a counseling appointment. Once you

violence in the workplace suffered by health

er apps that aid in their jobs. This reporting

research in violence prevention, and funding

have selected an option for either, your

care workers, we created a design solution

app would be one of them. We also want to

for violence prevention programs. This func-

feedback is immediately submitted. If

in the form of a Reporting App for nurses

take advantage of the digital device and the

tion is to clarify what exactly qualifies to be

you’ve asked to speak with your supervisor,

to use. Under reporting is one of the most

larger system this app is housed in, so that

reported, as well as why it is so important to

they will get back to you depending on

to fulfill our objec-

prevalent problems contributing to the wid-

any reporting process or documentation

report.

when you’ve requested to see them. The

tive of creating a

er problem space, and some statistics we

in the future will be a lot more streamlined

To report an incident, you click the icon

supervisor can also send you a message,

found show that 91% of healthcare workers

because of the information already stored

in the home screen or the pencil icon at the

letting you know in real time when they are

sense of action and

agree that violence is under reported. How-

in the system. A digital device also reaps

bottom bars of most screens. The entire

able to check in with you. If you’ve request-

ever, with systemic and cultural barriers that

immediate feedback, which is something a

form is a drop down menu, and you can ac-

ed counseling, they look at your schedule

address the issue of

contribute to the issue of under reporting,

paper-based reporting system simply can-

cess certain categories by swiping down. To

existing in the system, and get back to you

health care workers

only 28% of verbal abuse and 57% of phys-

not. This digital device will be about the size

enter information into a field that is a drop

with a list of possible dates where you can

ical violence is reported in writing. Systemic

of an iPad mini, which measures 5.3 x 7.87

down menu, just simply swipe right as the

book an appointment. This immediate

feeling like nothing

ing application that

barriers include the lack of a centralized

inches- just small enough to fit into pockets.

arrow prompts, and select an option. If your

feedback system is to fulfill our objective

promotes a positive

reporting system, confusion surrounding

When nurses arrive at work every day, they

desired option isn’t presented, you can click

of creating a sense of action and immedia-

what and why to report, and the lengthy

grab a tablet provided by the hospital and

“add custom label” and type in your own.

cy, and to address the issue of health care

process that takes too much time. Cultural

sign in once. Every other time they need to

This interactivity works for most of the form.

workers feeling like nothing is being done

barriers include the stigma of reporting and

access it, they just simply enter a previously

The use of more swiping rather than tap-

about their report. This is also to let them

being a victim of violence, the lack of per-

assigned PIN number for security measures.

ping is because of the ease of the swiping

know that these options are always available

Upon arriving at the home screen of

gesture, and the efficiency that comes with

to them.

“We aim to create a centralized report-

reporting experience through establishing a sense of action, transparency, and community.”

ceived support from administration, and the engrained care culture to always put others

the application, you have the option of

it. This will hopefully decrease the amount

first instead of themselves. With these is-

reporting an incident, checking previously

of time required to file a report.

sues in mind, for our Reporting App we aim

reported incidents, or learning more about

to create a centralized reporting application

reporting.

The reporting form is divided into eight

In the reporting forms, you also have

“This immediate

to work and aren’t able to finish their report in one sitting, the app will send them a pop

If the health care worker is unsure of

of WorkSafeBC’s Violence Reporting sam-

This ensures that the report will be filed de-

ence through establishing a sense of action,

what to report after an incident has hap-

ple forms and Vancouver Coastal Health’s

spite the many distractions workers encoun-

transparency, and community.

pened, they can click on the About button

code white forms. Because of the previously

ter throughout the day.

to learn about what violence and aggres-

stored information in this wider system of

solutions would be best translated in the

sion is defined as by Vancouver Coastal

the tablet, this reporting form is now stream-

care worker is taken to the Report Submit-

form of an app. We imagine our app to be

Health, and read some examples about

lined down to what we have presented.

ted page, where they are thanked for their

5 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

their report.”

If health care workers have to go back

up notification reminding them to finish.

We decided that our objectives and

immediacy, and to

is being done about

categories. The questions are all taken off

that promotes a positive reporting experi-

feedback system is

Upon submitting the report, the health

FINAL PROPOSED SOLUTION | 53

FINAL PROPOSED SOLUTION

Rationale W

hen Vancouver Coastal Health

in the future where nurses all have tablets

what that may be. They can also swipe right

approached Emily Carr University

that contain a larger system of patient charts

to learn about why reporting would benefit

the option to request a supervisor checkup

and provided us with the problem space of

and information, nurses schedules, and oth-

themselves, their colleagues, their patients,

or a counseling appointment. Once you

violence in the workplace suffered by health

er apps that aid in their jobs. This reporting

research in violence prevention, and funding

have selected an option for either, your

care workers, we created a design solution

app would be one of them. We also want to

for violence prevention programs. This func-

feedback is immediately submitted. If

in the form of a Reporting App for nurses

take advantage of the digital device and the

tion is to clarify what exactly qualifies to be

you’ve asked to speak with your supervisor,

to use. Under reporting is one of the most

larger system this app is housed in, so that

reported, as well as why it is so important to

they will get back to you depending on

to fulfill our objec-

prevalent problems contributing to the wid-

any reporting process or documentation

report.

when you’ve requested to see them. The

tive of creating a

er problem space, and some statistics we

in the future will be a lot more streamlined

To report an incident, you click the icon

supervisor can also send you a message,

found show that 91% of healthcare workers

because of the information already stored

in the home screen or the pencil icon at the

letting you know in real time when they are

sense of action and

agree that violence is under reported. How-

in the system. A digital device also reaps

bottom bars of most screens. The entire

able to check in with you. If you’ve request-

ever, with systemic and cultural barriers that

immediate feedback, which is something a

form is a drop down menu, and you can ac-

ed counseling, they look at your schedule

address the issue of

contribute to the issue of under reporting,

paper-based reporting system simply can-

cess certain categories by swiping down. To

existing in the system, and get back to you

health care workers

only 28% of verbal abuse and 57% of phys-

not. This digital device will be about the size

enter information into a field that is a drop

with a list of possible dates where you can

ical violence is reported in writing. Systemic

of an iPad mini, which measures 5.3 x 7.87

down menu, just simply swipe right as the

book an appointment. This immediate

feeling like nothing

ing application that

barriers include the lack of a centralized

inches- just small enough to fit into pockets.

arrow prompts, and select an option. If your

feedback system is to fulfill our objective

promotes a positive

reporting system, confusion surrounding

When nurses arrive at work every day, they

desired option isn’t presented, you can click

of creating a sense of action and immedia-

what and why to report, and the lengthy

grab a tablet provided by the hospital and

“add custom label” and type in your own.

cy, and to address the issue of health care

process that takes too much time. Cultural

sign in once. Every other time they need to

This interactivity works for most of the form.

workers feeling like nothing is being done

barriers include the stigma of reporting and

access it, they just simply enter a previously

The use of more swiping rather than tap-

about their report. This is also to let them

being a victim of violence, the lack of per-

assigned PIN number for security measures.

ping is because of the ease of the swiping

know that these options are always available

Upon arriving at the home screen of

gesture, and the efficiency that comes with

to them.

“We aim to create a centralized report-

reporting experience through establishing a sense of action, transparency, and community.”

ceived support from administration, and the engrained care culture to always put others

the application, you have the option of

it. This will hopefully decrease the amount

first instead of themselves. With these is-

reporting an incident, checking previously

of time required to file a report.

sues in mind, for our Reporting App we aim

reported incidents, or learning more about

to create a centralized reporting application

reporting.

The reporting form is divided into eight

In the reporting forms, you also have

“This immediate

to work and aren’t able to finish their report in one sitting, the app will send them a pop

If the health care worker is unsure of

of WorkSafeBC’s Violence Reporting sam-

This ensures that the report will be filed de-

ence through establishing a sense of action,

what to report after an incident has hap-

ple forms and Vancouver Coastal Health’s

spite the many distractions workers encoun-

transparency, and community.

pened, they can click on the About button

code white forms. Because of the previously

ter throughout the day.

to learn about what violence and aggres-

stored information in this wider system of

solutions would be best translated in the

sion is defined as by Vancouver Coastal

the tablet, this reporting form is now stream-

care worker is taken to the Report Submit-

form of an app. We imagine our app to be

Health, and read some examples about

lined down to what we have presented.

ted page, where they are thanked for their

5 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

their report.”

If health care workers have to go back

up notification reminding them to finish.

We decided that our objectives and

immediacy, and to

is being done about

categories. The questions are all taken off

that promotes a positive reporting experi-

feedback system is

Upon submitting the report, the health

FINAL PROPOSED SOLUTION | 53

report. This ensures a feeling that they are

ment, or track the report is offered again.

was solved through displaying statistics upon

not alone. They are also shown some data vi-

This is to let the worker know that these op-

submitting a report that shows the worker

sualizations of incidents reported vs incidents

tions are always available to them and will be

reporting is not alone, and is contributing to

resolved, rate of violent incidents in all BC

processed immediately, giving them a sense

the solution for the wider issue. The issue of

hospitals, and the type of violent incidents

of control and action over their own report.

a perceived lack of support in reporting is

that occur. The purpose of this page is to

“The “appreciate” button is a function

The health care worker can also track

address the issue of stigma in reporting, and

the reports they’ve filed under Checked

that workers know that their reports have

to let the care workers know that they are not

Reports. Here, they can see all the reports

benefitted their colleagues and perhaps

the only ones reporting. The data visual-

they’ve filed, as well as any their colleagues

even prevented another violent incident

izations remind them of the wider issue of

who have shared the same patient have

from happening. The issue of not knowing

violence, and emphasizes that their reporting

reported. Anything still bolded means it’s still

where the report goes once it’s filed is solved

is contributing to a solution for a wider issue.

active and unresolved, and anything greyed

through the track your report function, so

Once a report is submitted, other health

out means it’s already been resolved. If you

that workers know at all times where their

care workers who share the same patient as

select a specific profile, you can track how

report is and what is being done about it.

the worker who reported the incident will

the progress of the report is going with a

With all of these features we hope that our

get a notification about the report. This way,

timeline at the bottom of the report. You can

reporting application will create a positive re-

they are kept up to date on the state of their

also track how many appreciates you have

porting experience, which will then hopefully

patients, and possibly even then prevent

accumulated. To see other reports in the

solve the issue of under-reporting. Also, this

another violent incident from happening.

same category, you can swipe left or right.

app can contribute to more accurate data on

With this notification, they can either swipe

The purpose of this function is to provide

the issue, thus more research and funding to

right to “appreciate” it, or swipe left to view

a sense of transparency to the reporting

go into the violence prevention program at

the full report. The “appreciate” button is

process to address the issue of health care

Vancouver Coastal Health.

a function that lets the worker who filed the

workers not knowing where their report goes

report know that their efforts are appreci-

after being filed. With the Track your Report

ated, and possibly even prevented one of

function, workers can now see exactly where

their colleagues from not getting hurt by the

their report is at, and that something is being

same patient. “Appreciate” also is designed

done about it.

to build community among colleagues in the

In conclusion, we have established our

that lets the worker

workplace, to address the issue of a lack of

project objectives of creating a sense of

who filed the report

perceived support in reporting. The person

action, transparency, and community through

who has filed the report can then see all the

the problems we’ve been presented with.

know that their efforts are appreciated, and possibly even prevented one of their colleagues from not getting hurt by the same patient.”

solved through the appreciate function, so

“appreciates” they have received over time.

With workers being unsure of what to report,

If the worker has missed a notification about

this is solved through the about page, and

new appreciates, progress in their reports, or

providing information on what violence and

other incidents filed, it shows up as a notifi-

aggression is, and why reporting is important.

cation in the top bar.

With the issue of workers feeling like nothing

Check-up notifications happen over the

is being done, immediate feedback noti-

course of the worker’s shift, one at a half hour,

fication systems and check-ins ensure that

halfway through their shift, and right before

workers always have the option of speaking

the end of their shift. In the check-up notifi-

to a supervisor, requesting a counseling

cation, options to request a supervisor check

appointment, or tracking where their report

in, request a personal counseling appoint-

is. With the issue of stigma in reporting, this

5 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Final storyboards created to illustrate the usage of the app and all its features.

FINAL PROPOSED SOLUTION | 55

report. This ensures a feeling that they are

ment, or track the report is offered again.

was solved through displaying statistics upon

not alone. They are also shown some data vi-

This is to let the worker know that these op-

submitting a report that shows the worker

sualizations of incidents reported vs incidents

tions are always available to them and will be

reporting is not alone, and is contributing to

resolved, rate of violent incidents in all BC

processed immediately, giving them a sense

the solution for the wider issue. The issue of

hospitals, and the type of violent incidents

of control and action over their own report.

a perceived lack of support in reporting is

that occur. The purpose of this page is to

“The “appreciate” button is a function

The health care worker can also track

address the issue of stigma in reporting, and

the reports they’ve filed under Checked

that workers know that their reports have

to let the care workers know that they are not

Reports. Here, they can see all the reports

benefitted their colleagues and perhaps

the only ones reporting. The data visual-

they’ve filed, as well as any their colleagues

even prevented another violent incident

izations remind them of the wider issue of

who have shared the same patient have

from happening. The issue of not knowing

violence, and emphasizes that their reporting

reported. Anything still bolded means it’s still

where the report goes once it’s filed is solved

is contributing to a solution for a wider issue.

active and unresolved, and anything greyed

through the track your report function, so

Once a report is submitted, other health

out means it’s already been resolved. If you

that workers know at all times where their

care workers who share the same patient as

select a specific profile, you can track how

report is and what is being done about it.

the worker who reported the incident will

the progress of the report is going with a

With all of these features we hope that our

get a notification about the report. This way,

timeline at the bottom of the report. You can

reporting application will create a positive re-

they are kept up to date on the state of their

also track how many appreciates you have

porting experience, which will then hopefully

patients, and possibly even then prevent

accumulated. To see other reports in the

solve the issue of under-reporting. Also, this

another violent incident from happening.

same category, you can swipe left or right.

app can contribute to more accurate data on

With this notification, they can either swipe

The purpose of this function is to provide

the issue, thus more research and funding to

right to “appreciate” it, or swipe left to view

a sense of transparency to the reporting

go into the violence prevention program at

the full report. The “appreciate” button is

process to address the issue of health care

Vancouver Coastal Health.

a function that lets the worker who filed the

workers not knowing where their report goes

report know that their efforts are appreci-

after being filed. With the Track your Report

ated, and possibly even prevented one of

function, workers can now see exactly where

their colleagues from not getting hurt by the

their report is at, and that something is being

same patient. “Appreciate” also is designed

done about it.

to build community among colleagues in the

In conclusion, we have established our

that lets the worker

workplace, to address the issue of a lack of

project objectives of creating a sense of

who filed the report

perceived support in reporting. The person

action, transparency, and community through

who has filed the report can then see all the

the problems we’ve been presented with.

know that their efforts are appreciated, and possibly even prevented one of their colleagues from not getting hurt by the same patient.”

solved through the appreciate function, so

“appreciates” they have received over time.

With workers being unsure of what to report,

If the worker has missed a notification about

this is solved through the about page, and

new appreciates, progress in their reports, or

providing information on what violence and

other incidents filed, it shows up as a notifi-

aggression is, and why reporting is important.

cation in the top bar.

With the issue of workers feeling like nothing

Check-up notifications happen over the

is being done, immediate feedback noti-

course of the worker’s shift, one at a half hour,

fication systems and check-ins ensure that

halfway through their shift, and right before

workers always have the option of speaking

the end of their shift. In the check-up notifi-

to a supervisor, requesting a counseling

cation, options to request a supervisor check

appointment, or tracking where their report

in, request a personal counseling appoint-

is. With the issue of stigma in reporting, this

5 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Final storyboards created to illustrate the usage of the app and all its features.

FINAL PROPOSED SOLUTION | 55

FINAL PROPOSED SOLUTION

Gantt Chart + Self Assessment DESN 310 Assignment 2: Violence in Healthcare

Gantt Chart Cheryl Li, Lauren Henderson

Self Assessment

Sa Su M Tu W Th F Sa Su M Tu W Th 19 20 21 22 23 24 25 26 27 28 29 30 31

F Sa Su M Tu W 1 2 3 4 5 6

Literature Review

O

verall, we think that we’ve succeeded in fufilling our thesis’ goal of creating

Co-Creation Exploration Navigation Color + Type Selection

creative and innovative solutions that are still

creates a sense of transparency, action and

appropriate.

2nd Draft Refinement Interactivity Process Book - Research Process Book - Drafts Presentation

All in all, we worked well on our project

believe that nurses would feel less intimidated

within our team. Normally, we would meet

when reporting with our app and this would

about three time a week and go away each

therefore boost reporting violence in health

time with different or the same task and then

care. Currently however this is based on

meet again to discuss our findings, and see

assumption, and cannot yet be verified

the different ways each of us would solve a

without user testing.

problem. This worked well to be able to gain

We believe that we were successful in

1st Draft

further, so that we could come up with more

an easy to use reporting app that also community within the reporting system. We

Context Research

reporting and exploring our solution ideas

perspective in our own work with the input of

pulling validated information from our sec-

our partner. Using a Gantt Chart really helped

ondary research and co-creation and apply-

us stay on track mostly in the beginning and

ing it to our final concept. we found that our

middle stages of our process. However in the

design really was informed by our research

end stages of refinement it became harder

and this actually made the design process go

to follow. One main motivator for our project

smoother.

was the constant reminder that this project

If we were to do this project over, we

would ultimately benefit the client, and that

would like to expand our idea further into the

this was actually a real wicked problem that

entire system of use. We would explore how

health care workers face in their every day

supervisors and administrators would also

work lives.

use our app in conjunction with nurses. We wonder how supervisors would see reports and update nurses on their status. In addi-

Exploring, Conceptualizing

Implementing, Refining

tion, as mentioned at our presentation one of the reasons apps such as this do not exist yet is do to the patient privacy concerns. If we were to do this project over we would have researched further into this obstacle.

For our process, if we could repeat this project we would spend more time at the ideating phase of how to solve the issue of

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FINAL PROPOSED SOLUTION | 57

FINAL PROPOSED SOLUTION

Gantt Chart + Self Assessment DESN 310 Assignment 2: Violence in Healthcare

Gantt Chart Cheryl Li, Lauren Henderson

Self Assessment

Sa Su M Tu W Th F Sa Su M Tu W Th 19 20 21 22 23 24 25 26 27 28 29 30 31

F Sa Su M Tu W 1 2 3 4 5 6

Literature Review

O

verall, we think that we’ve succeeded in fufilling our thesis’ goal of creating

Co-Creation Exploration Navigation Color + Type Selection

creative and innovative solutions that are still

creates a sense of transparency, action and

appropriate.

2nd Draft Refinement Interactivity Process Book - Research Process Book - Drafts Presentation

All in all, we worked well on our project

believe that nurses would feel less intimidated

within our team. Normally, we would meet

when reporting with our app and this would

about three time a week and go away each

therefore boost reporting violence in health

time with different or the same task and then

care. Currently however this is based on

meet again to discuss our findings, and see

assumption, and cannot yet be verified

the different ways each of us would solve a

without user testing.

problem. This worked well to be able to gain

We believe that we were successful in

1st Draft

further, so that we could come up with more

an easy to use reporting app that also community within the reporting system. We

Context Research

reporting and exploring our solution ideas

perspective in our own work with the input of

pulling validated information from our sec-

our partner. Using a Gantt Chart really helped

ondary research and co-creation and apply-

us stay on track mostly in the beginning and

ing it to our final concept. we found that our

middle stages of our process. However in the

design really was informed by our research

end stages of refinement it became harder

and this actually made the design process go

to follow. One main motivator for our project

smoother.

was the constant reminder that this project

If we were to do this project over, we

would ultimately benefit the client, and that

would like to expand our idea further into the

this was actually a real wicked problem that

entire system of use. We would explore how

health care workers face in their every day

supervisors and administrators would also

work lives.

use our app in conjunction with nurses. We wonder how supervisors would see reports and update nurses on their status. In addi-

Exploring, Conceptualizing

Implementing, Refining

tion, as mentioned at our presentation one of the reasons apps such as this do not exist yet is do to the patient privacy concerns. If we were to do this project over we would have researched further into this obstacle.

For our process, if we could repeat this project we would spend more time at the ideating phase of how to solve the issue of

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FINAL PROPOSED SOLUTION | 57

FINAL PROPOSED SOLUTION

Bibliography Article: Drawing the Line: Shutting Down Verbal Abuse - Nurse Colleague / Patient Relations. (n.d.). Retrieved October 19, 2013, from http://allnurses.com/nurse-colleague-patient/ drawing-line-shutting-839058.html

Provincial Violence Prevention Curriculum Team. (2011). Violence prevention - participant guide. Retrieved from http://jonathanaitken.ca/wp-content/uploads/2012/01/1-Behavioural_ Care_Planning_Participant_Final_Print-Sept-2012.pdf

Design Council - Case Studies. (n.d.). Retrieved November 9, 2013, from http://www. designcouncil.org.uk/our-work/challenges/Health/Design-for-Patient-Dignity/Case-studies/

Reducing Violence And Aggression In A&E By Design | Our Work | Design Council. (n.d.).

Retrieved October 20, 2013, from http://www.designcouncil.org.uk/our-work/challenges/ health/ae/

Fernandes, C., & Bouthillette, F. (1999). Violence In The Emergency Department: A Survey Of Health Care Workers. Canadian Medical Association, Retrieved from http://www.cmaj.ca/ content/161/10/1245.full.pdf Frog’s Connected Care Solution | Blog | Design Mind. (n.d.). Retrieved November 9, 2013, from http://designmind.frogdesign.com/blog/frog-s-connected-care-solution.html Health Care - Injury Prevention - Violence. (n.d.). Retrieved November 9, 2013, from http:// www2.worksafebc.com/Portals/HealthCare/Violence.asp Nurses’ Experience Of Violence In Alberta And... [Can J Nurs Res. 2001] - Pubmed - Ncbi. (n.d.). Retrieved November 9, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/11928302 Nurse Knowledge Exchange | IDEO. (n.d.). Retrieved November 9, 2013, from http://www. ideo.com/work/nurse-knowledge-exchange/

Violence In The Workplace : Osh Answers. (n.d.). Retrieved November 9, 2013, from http:// www.ccohs.ca/oshanswers/psychosocial/violence.html Worksafebc Videos - Care For Those Who Care For You (Violence In Health Care). (n.d.).

Retrieved November 9, 2013, from http://www2.worksafebc.com/Publications/Multimedia/ Videos.asp?ReportID=36006 WorkSafeBC Videos - Forever Changed. (n.d.). Retrieved November 9, 2013, from http:// www2.worksafebc.com/Publications/Multimedia/Videos.asp?ReportID=35357 5 Tips For Reducing Violence In Your Hospital | CPI. (n.d.). Retrieved October 20, 2013, from http://www.crisisprevention.com/Blogs/Care-Connections-Balancing-Care-With-Safety/April2013/5-Tips-for-Reducing-Violence-in-Your-Hospital

Ohsah: Fact Sheet Violence Study. Research Update. (2009). Retrieved from http:// www.phsa.ca/NR/rdonlyres/6C69D638-8587-4096-A8AA-7D2B0141C3B2/59693/ FactSheetViolenceinHealthcareWorkerSurvey.pdf Overview and Summary: Patient and Visitor Violence: What Do We Know? What Can We Do? (n.d.). Retrieved November 9, 2013, from http://www.nursingworld.org/MainMenuCategories/ ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/ Overview-and-Summary-Patient-and-Visitor-Violence.html Provincial Violence Prevention Steering Committee. (2009). Behaviour documentation toolkit. Retrieved from http://www.phsa.ca/NR/rdonlyres/6C69D638-8587-4096-A8AA7D2B0141C3B2/59711/ToolkitOHSAHBehaviourDocumentationtoolkit.pdf

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FINAL PROPOSED SOLUTION

Bibliography Article: Drawing the Line: Shutting Down Verbal Abuse - Nurse Colleague / Patient Relations. (n.d.). Retrieved October 19, 2013, from http://allnurses.com/nurse-colleague-patient/ drawing-line-shutting-839058.html

Provincial Violence Prevention Curriculum Team. (2011). Violence prevention - participant guide. Retrieved from http://jonathanaitken.ca/wp-content/uploads/2012/01/1-Behavioural_ Care_Planning_Participant_Final_Print-Sept-2012.pdf

Design Council - Case Studies. (n.d.). Retrieved November 9, 2013, from http://www. designcouncil.org.uk/our-work/challenges/Health/Design-for-Patient-Dignity/Case-studies/

Reducing Violence And Aggression In A&E By Design | Our Work | Design Council. (n.d.).

Retrieved October 20, 2013, from http://www.designcouncil.org.uk/our-work/challenges/ health/ae/

Fernandes, C., & Bouthillette, F. (1999). Violence In The Emergency Department: A Survey Of Health Care Workers. Canadian Medical Association, Retrieved from http://www.cmaj.ca/ content/161/10/1245.full.pdf Frog’s Connected Care Solution | Blog | Design Mind. (n.d.). Retrieved November 9, 2013, from http://designmind.frogdesign.com/blog/frog-s-connected-care-solution.html Health Care - Injury Prevention - Violence. (n.d.). Retrieved November 9, 2013, from http:// www2.worksafebc.com/Portals/HealthCare/Violence.asp Nurses’ Experience Of Violence In Alberta And... [Can J Nurs Res. 2001] - Pubmed - Ncbi. (n.d.). Retrieved November 9, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/11928302 Nurse Knowledge Exchange | IDEO. (n.d.). Retrieved November 9, 2013, from http://www. ideo.com/work/nurse-knowledge-exchange/

Violence In The Workplace : Osh Answers. (n.d.). Retrieved November 9, 2013, from http:// www.ccohs.ca/oshanswers/psychosocial/violence.html Worksafebc Videos - Care For Those Who Care For You (Violence In Health Care). (n.d.).

Retrieved November 9, 2013, from http://www2.worksafebc.com/Publications/Multimedia/ Videos.asp?ReportID=36006 WorkSafeBC Videos - Forever Changed. (n.d.). Retrieved November 9, 2013, from http:// www2.worksafebc.com/Publications/Multimedia/Videos.asp?ReportID=35357 5 Tips For Reducing Violence In Your Hospital | CPI. (n.d.). Retrieved October 20, 2013, from http://www.crisisprevention.com/Blogs/Care-Connections-Balancing-Care-With-Safety/April2013/5-Tips-for-Reducing-Violence-in-Your-Hospital

Ohsah: Fact Sheet Violence Study. Research Update. (2009). Retrieved from http:// www.phsa.ca/NR/rdonlyres/6C69D638-8587-4096-A8AA-7D2B0141C3B2/59693/ FactSheetViolenceinHealthcareWorkerSurvey.pdf Overview and Summary: Patient and Visitor Violence: What Do We Know? What Can We Do? (n.d.). Retrieved November 9, 2013, from http://www.nursingworld.org/MainMenuCategories/ ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/ Overview-and-Summary-Patient-and-Visitor-Violence.html Provincial Violence Prevention Steering Committee. (2009). Behaviour documentation toolkit. Retrieved from http://www.phsa.ca/NR/rdonlyres/6C69D638-8587-4096-A8AA7D2B0141C3B2/59711/ToolkitOHSAHBehaviourDocumentationtoolkit.pdf

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